Scoring model for the diagnosis of colorectal perforation and its differentiation from gastroduodenal perforation.

Purpose: Distinguishing colorectal from gastroduodenal perforations is clinically important and challenging. We aimed to establish a scoring model based on objective findings (excluding computed tomography findings) for the diagnosis of colorectal perforation and its differentiation from gastroduodenal perforation.

Methods: Patients diagnosed with colorectal or gastroduodenal perforations between January 2014 and December 2021 were retrospectively studied.

A Standardized Interrupted Parachute Suture Technique in Hepaticojejunostomy for Patients With Perihilar Cholangiocarcinoma.

Background/aim: Although hepaticojejunostomy is a relatively uncomplicated surgical procedure, its postoperative complications can range from a prolonged hospital stay to death. In hepatectomy, including resection of the perihilar bile duct for perihilar cholangiocarcinoma, the difficulty of performing hepaticojejunostomy and the complication rate increase due to the characteristics of surgery required for perihilar cholangiocarcinoma. In this study, we standardized the interrupted parachute suture technique and examined its safety and efficacy.

Early Identification of Patients with Potential Failure of Nonoperative Management for Gastroduodenal Peptic Ulcer Perforation.

Introduction: We aimed to identify objective factors associated with failure of nonoperative management (NOM) of gastroduodenal peptic ulcer perforation (GDUP) and establish a scoring model for early identification of patients in whom NOM of GDUP may fail.

Methods: A total of 71 patients with GDUP were divided into NOM (cases of NOM success) and operation groups (cases requiring emergency operation or conversion from NOM to operation). Using logistic regression analysis, a scoring model was established based on the independent factors.

Preoperative scoring system for prediction of extended resection during emergency surgery for acute appendicitis.

Purpose: Appendicectomy is the primary treatment for acute appendicitis. However, extended resection (ER) may be required in difficult cases. Preoperative prediction of ER may identify challenging cases but remains difficult.

Exposure of the hepatic vein trunk via tracing of its branches: a useful surgical procedure for laparoscopic anatomical hepatectomy.

Background: Although there are various advantages of laparoscopic liver resection (LLR) over open liver resection, some problems have been reported, such as disorientation and lack of control of bleeding during liver parenchymal dissection. In this study, we discuss a strategy to overcome the disorientation experienced during liver parenchymal dissection, especially in anatomical LLR.

Technical Presentation: This procedure involves hepatic parenchymal dissection from the hepatic vein branch along its trunk to reveal an important landmark in anatomical LLR.

Development of a scoring model based on objective factors to predict gangrenous/perforated appendicitis.

Background: The mortality rate of gangrenous/perforated appendicitis is higher than that of uncomplicated appendicitis. However, non-operative management of such patients is ineffective. This necessitates their careful exam at presentation to identify gangrenous/perforated appendicitis and aid surgical decision-making.

Risk factors for postoperative disseminated intravascular coagulation in surgical patients with non-occlusive mesenteric ischemia.

Purpose: The prognostic impact of disseminated intravascular coagulation (DIC) in surgical patients with non-occlusive mesenteric ischemia (NOMI) is unclear. This study aimed to confirm the association between postoperative DIC and prognosis and to identify preoperative risk factors associated with postoperative DIC.

Methods: This retrospective study included 52 patients who underwent emergency surgery for NOMI between January 2012 and March 2022.

Efficacy of CT Value Along Portal Vein for Preoperative Prediction of Portal Vein Resection in Pancreatic Head Cancer.

Background: It is important for surgeons to determine whether combined portal vein (PV) resection (PVR) is necessary before surgery. The present study aimed to determine the ability of computed tomography (CT) value along the PV in predicting the necessity for concomitant PVR.

Methods: A total of 107 consecutive patients who underwent pancreaticoduodenectomy (PD) for invasive ductal carcinoma of the pancreatic head at our institute between September 2007 and September 2020 were reviewed retrospectively.

Impact of atherosclerosis on the postoperative complications of colorectal surgery in older patients with colorectal cancer.

Background: Atherosclerosis is associated with various comorbidities; nonetheless, its effect on the postoperative complications of colorectal surgery in older patients with colorectal cancer (CRC) remains unclear. This study aimed to evaluate the impact of atherosclerosis on the postoperative complications of colorectal surgery in older adults with CRC.

Methods: Patients aged ≥ 65 years who underwent surgery for CRC between April 2017 and October 2020 were enrolled.

Prediction model for irreversible intestinal ischemia in strangulated bowel obstruction.

Background: Preoperatively diagnosing irreversible intestinal ischemia in patients with strangulated bowel obstruction is difficult. Therefore, this study aimed to establish a prediction model for irreversible intestinal ischemia in strangulated bowel obstruction.

Methods: We included 83 patients who underwent emergency surgery for strangulated bowel obstruction between January 2014 and March 2022.

HOXB9 mediates resistance to chemotherapy and patient outcomes through the TGFβ pathway in pancreatic cancer.

Background: Although HOXB9 induces tumor proliferation and chemoresistance in several cancer cells, little is known in pancreatic ductal adenocarcinoma (PDAC). In the present study, increased expression of HOXB9 in PDAC was associated with the induction of angiogenic factors and poor overall survival through the TGFβ pathway. Taken together, these results suggested that HOXB9 expression in PDAC could be a surrogate marker in clinical treatment.

Prognostic Impact of N2 of the Primary Tumour in Surgical Resection for Colorectal Liver Metastases.

Background/aim: The status of lymph node metastasis of primary tumours remains to be completely investigated. This study investigated the prognostic impact of the degree of primary lymph node metastasis in patients with colorectal liver metastasis.

Patients And Methods: We retrospectively analysed the clinical data of 106 patients with colorectal liver metastases who underwent surgical resection.

Retropancreatic Nerve Plexus Hanging Maneuver for Pancreatoduodenectomy for Cancer of the Head of the Pancreas.

The efficacy of the hanging maneuver for the retropancreatic nerve plexus (RNP) to enhance the confirmation of the margin status and to facilitate en-bloc resection for pancreatoduodenectomy is studied. The exit of the hanging maneuver of the RNP is the left part of the superior mesenteric artery, and the entry is the cranial part of the celiac axis. The entry of the hanging maneuver was connected to the dissection line on the right side of the celiac axis.

Handling of Hilar Vasculature in Living Donor Right Hepatectomy Using Extrahepatic Glissonean Approach.

Donor hepatectomy is one of the most important procedures in LDLT because it affects the safety of donors and the outcome of the recipients. We standardized a method of securing the important vessels at the hepatic hilum while advancing the dissection toward the central direction. This research introduces our technique of handling hilar vasculature in living donor hepatectomy, using the extrahepatic Glissonean approach, and discusses its efficacy.

New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study.

Background: Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery.

Prognostic value of future liver remnant LU15 index of 99mTc-galactosyl serum albumin scintigraphy for predicting posthepatectomy liver failure.

There is no gold standard indicator that is currently used to predict posthepatectomy liver failure (PHLF). A novel indicator of liver function, the LU15 index of 99mTc-galactosyl serum albumin (GSA) scintigraphy, refers to the liver uptake ratio over a 15-min interval. We aimed to evaluate the usefulness of the future liver remnant (FLR)-LU15 in predicting PHLF.

A New Preoperative Risk Score for Predicting Postoperative Complications in Elderly Patients Undergoing Hepatectomy.

Background: Postoperative complications are not rare in the elderly population after hepatectomy. However, predicting postoperative risk in elderly patients undergoing hepatectomy is not easy. We aimed to develop a new preoperative evaluation method to predict postoperative complications in patients above 65 years of age using biological impedance analysis (BIA).

Prognostic Significance of Plasma Fibrinogen/Serum Albumin Ratio in the Postoperative Outcome of Pancreatic Ductal Adenocarcinoma.

Background/aim: Surgery is an important pancreatic ductal adenocarcinoma (PDAC) treatment; existing markers are inadequate prognostic indexes. We herein evaluated the utility of the FA score (fibrinogen/albumin ratio) for predicting PDAC postoperative outcomes.

Patients And Methods: We analysed the data of 67 PDAC patients who underwent surgical resection.

Risk Factors for Life-threatening Grade C Postoperative Pancreatic Fistula After Pancreatoduodenectomy Compared to Grade B.

Background: The aim of the present study was to investigate risk factors for the development of grade C compared to grade B cases of postoperative pancreatic fistula (POPF).

Materials And Methods: Clinicopathological data from 43 patients who developed grade B or C POPF were retrospectively analyzed. The following types of factors were analyzed: Patient-related, surgery-related, and pancreas-related, including the value of the drain amylase and the detection of gram-negative rod bacteria within the first 7 postoperative days (PODs).

Resection of a pancreatic capillary lymphatic malformation through a partial pancreatectomy: a case report.

Background: Pancreatic vascular malformation causes epigastric pain, pancreatitis, portal vein hypertension, bleeding, and rupture. It is a rare disease, with most pancreatic vascular malformations being arteriovenous malformations (AVMs) and the other types of malformations being rare. We report a case of capillary lymphatic malformation (CLM) in the pancreatic uncinate process.

Resection of Hepatic Lesions Perfused by the Cholecystic Vein Using Indocyanine Green Navigation in Patients with cT2 Gallbladder Cancer.

Background: Various approaches to hepatectomy have been proposed for cT2 gallbladder cancers (GBC), but the optimal management strategy remains unclear. The aim of this study is to assess the effectiveness of using an indocyanine green (ICG)-based intraoperative navigation system during hepatic resection for cT2 GBC.

Methods: From September 2007 to December 2017, 24 consecutive patients diagnosed with cT2 GBC underwent hepatic resection using ICG navigation.

The diagnostic value of 99m-Tc GSA scintigraphy for liver function and remnant liver volume in hepatic surgery: a retrospective observational cohort study in 27 patients.

Background: The aim was to analyze hepatic hypertrophy after portal vein embolization (PVE) and Associating Liver Partition with Portal vein ligation for Staged hepatectomy (ALPPS) to determine whether clinical circumstances associated with major hepatic resections correlated with remnant growth.

Methods: Data was abstracted from a retrospectively maintained database on 27 patients undergoing hepatic resection followed by PVE and the ALPPS procedure between October 1, 2007 and December 31, 2016. The increasing rate of liver volume and remnant liver LU15 was defined as the percentage-point difference between the liver volume and remnant liver LU15 before and after the intervention or surgery.

Superficial Surgical Site Infection in Hepatobiliary-Pancreatic Surgery: Subcuticular Suture Versus Skin Staples.

Purpose: Postoperative superficial surgical site infection is a major complication in hepatobiliary-pancreatic surgery. We aimed to compare the efficacy of subcuticular sutures versus staples for skin closure in preventing superficial surgical site infection in hepatobiliary-pancreatic surgery.

Methods: Consecutive patients who underwent hepatobiliary-pancreatic surgery at our hospital from October 2006 to March 2011 and from April 2012 to March 2015 were reviewed retrospectively.